SEC Form 4 · accession 0001375551-16-000035
DCP Holding CO
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Anthony A Cook
Officer — President & CEO · Director
Period of report
Dec 31, 2015
Accepted (ET)
Jan 4, 2016 · 11:32 am EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001361025
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Phantom StockF1,F2 | — | Dec 31, 2015 | P | 2 | A | — | — | Class B Common Shares | 2 | 134 | D |
Explanation of responses
- F1Each share of Phantom Stock is the economic equivalent of one Class B Common Share.
- F2The Reporting Person acquired the Phantom Stock by electing to defer compensation into Phantom Stock under the Issuer's Deferred Compensation Plan. Pursuant to such election, the Phantom Stock will be settled in cash upon the Reporting Person's termination of employment with the Issuer.